Antibiotic prescribing patterns in Ghana, Uganda, Zambia and Tanzania hospitals: Results from the global point prevalence survey (G-PPS) on antimicrobial use and stewardship interventions implemented

Nikki D’Arcy, Diane Ashiru-Oredope*, Omotayo Olaoye, Daniel Afriyie, Zainab Akello, Daniel Ankrah, Derrickmawuena Asima, David C. Banda, Scott Barrett, Claire Brandish, Joseph Brayson, Peter Benedict, Cornelius C. Dodoo, Frances Garraghan, Josephyn Hoyelah, Yogini Jani, Freddy Eric Kitutu, Ismail Musoke Kizito, Appiah Korang Labi, Mariyam MirfendereskySudaxshina Murdan, Caoimhe Murray, Noah Obeng-Nkrumah, William J’Pathim Olum, Japheth Awuletey Opintan, Edwin Panford-Quainoo, Ines Pauwels, Israel Sefah, Jacqueline Sneddon, Anja St Clair Jones, Ann Versporten

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Antimicrobial resistance (AMR) remains an important global public health issue with antimicrobial misuse and overuse being one of the main drivers. The Global Point Prevalence Survey (G-PPS) of Antimicrobial Consumption and Resistance assesses the prevalence and the quality of antimicrobial prescriptions across hospitals globally. G-PPS was carried out at 17 hospitals across Ghana, Uganda, Zambia and Tanzania. The overall prevalence of antimicrobial use was 50% (30-57%), with most antibiotics prescribed belonging to the WHO ‘Access’ and ‘Watch’ categories. No ‘Reserve’ category of antibiotics was prescribed across the study sites while antimicrobials belonging to the ‘Not Recommended’ group were prescribed infrequently. Antimicrobials were most often prescribed for prophylaxis for obstetric or gynaecological surgery, making up between 12 and 18% of total prescriptions across all countries. The most prescribed therapeutic subgroup of antimicrobials was ‘Antibacterials for systemic use’. As a result of the programme, PPS data are now readily available for the first time in the hospitals, strengthening the global commitment to improved antimicrobial surveillance. Antimicrobial stewardship interventions developed included the formation of AMS committees, the provision of training and the preparation of new AMS guidelines. Other common interventions included the presentation of findings to clinicians for increased awareness, and the promotion of a multi-disciplinary approach to successful AMS programmes. Repeat PPS would be necessary to continually monitor the impact of interventions implemented. Broader participation is also encouraged to strengthen the evidence base.

Original languageEnglish
Article number1122
Issue number9
Publication statusPublished - Sep 2021
Externally publishedYes

Bibliographical note

Funding Information:
The Commonwealth Partnerships for Antimicrobial Stewardship programme (Cw-PAMS), managed by the Commonwealth Pharmacists Association (CPA) and Tropical Health and Education Trust (THET), is a health partnerships programme funded by the UK Official Development Assistance (ODA), through the Department of Health and Social Care’s Fleming Fund to address AMR globally [17]. The aim of the programme is to enhance the implementation of protocols and evidenced-based decision making to support antimicrobial prescribing and the capacity for surveillance of antimicrobial consumption and stewardship.

Publisher Copyright:
© 2021 by the authors. Licensee MDPI, Basel, Switzerland.


  • Antibiotics
  • Antimicrobial resistance
  • Antimicrobial stewardship
  • Antimicrobial surveillance
  • Antimicrobials
  • Global-pps


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